Flexible, affordable, benefit-rich options
Medshield Medical Scheme, the fourth largest open scheme in South Africa, has announced an average family rate increase for 2012 of R294.34. In operation for over 40 years, the scheme's management says Medshield's resilience in an increasingly challenging environment is evident through its active expansion into the private sector. Last year the company successfully took on Oxygen and Gen-Health members, resulting in a principal membership of over 100 000, covering 254 000 lives.
Medshield's basket of options for 2012 is designed to provide for a broad cross-section of healthcare requirements across its New Generation and Traditional plans. The products are designed to be flexible, affordable and benefit-rich for every life-stage and underpin the offering for the year ahead. The company says that these factors, together with its continued financial stability, present a compelling proposition to members.
Duduza Khosana, Medshield's executive principal officer, comments, "Our financial credentials, as reviewed recently by Global Credit Ratings, indicate a healthy scheme. For the sixth consecutive year Medshield has achieved an AA- rating, the second highest rating a scheme can achieve." She continues, "GCR also noted a healthy solvency margin and liquidity was measured at comfortable levels, so our members know they are partnering with a robust scheme - a rare asset in the current market."
Medshield has consolidated its positioning in two market categories, retail and group. The basket of retail product offerings has five different options designed to provide medical cover for individual members with different healthcare needs. Collectively they are designed to provide a full spectrum for the individual retail market. These options are as follows:
Retail options
Premium Plus (New Generation): Premium Plus is a New Generation option and offers unlimited in-hospital cover, with certain in-hospital procedures paid at a higher than medical scheme tariff. In-hospital co-payments for specified procedures have been reduced by 50%. Premium Plus is best suited for families of corporate individuals, who have the financial acumen of managing their own out-of-hospital medical requirements through their Personal Savings Account.
Standard Cover (New Generation): Standard Cover is a New Generation option which offers unlimited in-hospital cover and provides for surgical and non-surgical procedures to be paid at higher than medical scheme tariff. It is best suited for newlyweds thinking of starting a family - an added out-of-hospital maternity package is payable from risk. These individuals enjoy managing their own out-of-hospital medical requirements from their Personal Savings Account.
Core Plus (Hospital Plan): The Core Plus option is a hospital plan with unlimited in-hospital cover with surgical and non-surgical procedures being covered at higher than medical scheme tariff. It is best suited for young individuals who want to ensure that their major medical emergencies are covered.
80% Plan (New Generation): This plan is a Traditional option which offers unlimited in-hospital cover and is best suited for mature individuals who are willing to cover a portion of their medical expenses themselves.
Essential (New Generation): Essential is an option with limited in-hospital cover, suitable for young, healthy, single, private individuals who are starting out in life. They are able to manage their out-of-hospital benefits through their Personal Savings Account, but still have the assurance that they are covered for hospitalisation in case of an emergency.
Group options
Medshield's group options are traditional options specifically tailored to meet the needs of employer groups. The group offering has stated out-of-hospital benefits such as GP visits and optical, with an additional AMEL (Annual Medical Expense Limit) for specialist, pathology and acute medicines. These options are as follows:
MediBonus (Traditional): MediBonus is a Traditional option which offers unlimited in-hospital cover with co-payments on non-PMB (Prescribed Minimum Benefits) procedures. Out-of-hospital cover consists of stated benefits which include General Practitioner (GP) visits, Optical and Dental benefits together with a Medical Expense Limit for specialist, radiology and pathology. This option is best suited for mature professionals of medium to large enterprises.
MediPlus (Traditional): MediPlus is a Traditional option which offers unlimited in-hospital cover with co-payments on non-PMB (Prescribed Minimum Benefits) procedures. Out-of-hospital cover consists of stated benefits which include General Practitioner (GP) visits, Optical and Dental benefits together with a Medical Expense Limit for specialist, radiology and pathology. It is best suited for mature professionals of medium to large enterprises.
MediValue (Traditional): MediValue offers limited in-hospital cover, up to R300 000 per family, with limited stated out-of-hospital benefits. The option is targeted at single individuals or young couples who belong to medium to large enterprises.
The benefits and rates are applicable from 1 January 2012, subject to approval by CMS.
